The feasibility of using hyperpolarized 13C to interrogate in vivo human metabolism in the healthy heart has recently been demonstrated. In this abstract we demonstrate the feasibility of using hyperpolarized 13C imaging to detect metabolic alterations in human hypertrophic cardiomyopathy. Results show significantly elevated 13C-bicarbonate-to-pyruvate ratio near the apex of the heart, corresponding to the known location of disease. The 13C-bicarbonate images also show a different spatial distribution from those observed in healthy volunteers. These results show good prospects for imaging the altered cardiac energetics in the diseased heart using this technology.